a braingate device could literally go anywhere in their wheelchair and carry the whole system with them. coyote: the same futuristic thinking is driving research in ed boyden's lab at the massachusetts institute of technology, as he explores the possibility of the emerging technology of light therapy. ed boyden: the brain is not just a single homogeneous system it's got many circuit elements, many neurons that project from one part to another and are wired in a very complicated way. and what's important to realize is that we have to find ways to modulate one circuit in the brain, the one that's having trouble, without altering the other parts of the brain that are normal. we and many other groups have started to be very interested in nerve modulation therapies, the use of light to turn cells in the brain on and off. the technologies are being used by a group at case western reserve university, and what they're doing is they are finding ways to take spinal cord injury models and to optically modulate neurons in the spinal cord. if they optically modulate neurons below the fracture they can restore breathing patterns.

they think that this works by using light to modulate neurons is engaging the natural plasticity mechanisms in the spinal cord that are dormant, but if you drive activity in the right pattern then you can get recovery of those patterns of activity and they sort of start creating the rhythms of breathing by themselves even though they don't normally do that. coyote: dr. boyden's team discovered that the breathing circuit actually continued to work, even with the light therapy disengaged, showing the amazing power of plasticity. boyden: plasticity is a very important feature of the nervous system and i think a lot of the therapies that we like to develop will engage the natural plasticity mechanisms in the brain rather than try to simply replace them coyote: both the braingate and the optometrics in dr. ed boyden's research are still in the very earliest stages of discovery, but their work holds a great deal of promise for the future, incorporating newer technologies and the power of brain plasticity. today, positive neuroplasticity can create real

and immediate changes, even with something as seemingly insurmountable as a stroke. bach y rita: i was in medical school in mexico city. i got a call and they said, "come pick your father, he's had a stroke and he's in very bad shape." my father had drive. he was not going to sit still for it. and he trusted me and i said, "we're going to do something about this. i don't know what but we're going to do something about this." the only model for learning how to walk was the first model, children. i said, this is what you did when you started to walk the first time. let's see if you can do it the second time. and there was also a practical side. my father just hated being dependent. he could not tolerate being dependent. at first he was on his elbow really because he couldn't straighten his arm out properly. but after a while he was crawling on hands and knees.

and he got to the point where he could crawl up the stairs. little by little, things came back.the more he struggled with it, the more came back. coyote: pedro bach y rita was basically cured by his therapy with his son george. he remarried, returned to his role as a professor at the city college of new york and enjoyed a very active life. merznech: well, when you have a stroke you have a hole in the machine and the extent to which you have a hole in it, if it's physically damaged you can't recover that. i mean, that's lost, but the brain has a remarkable ability to compensate. to put activities that were represented in that location in the new location. or to compensate by changing the behavior in a way that it still works even though it's not done neurologically in the identical way. coyote: bach y rita had such remarkable success with his therapy because he put his focus not on the skill, like walking, but how the skill was acquired,

the learning process. that is how changes take place in our brain through new skill acquisition. but it has to be the right type of learning to direct positive plastic changes. positive neuroplasticity pushes the boundaries of what science expects with the outcome of a stroke. and when it comes to other extreme injuries to the brain, positive brain plasticity approaches can also have a tremendous impact, for instance, with victims of traumatic brain injury. valerie: the phone rang around 6:20 and i looked at caller id and it said fort campbell, and i knew. you know? and so i just said "john's my son, is he okay?" and he said, "ma'am there's been an incident." john: well, i remember running up to a humvee to start unloading it and all i remember was falling down and i thought i smacked my head on my rifle.

when i got up i wiped my forehead and there was a little bit of blood on it. and i guess the mortar round had exploded about five feet away from me. and shrapnel had gone straight through my helmet and straight through my head. coyote: john barnes effected arm had almost no dexterity with his fingers and a greater loss at the shoulder and elbow. taub: there was almost nothing that he could do with the arm. begley: if you constrain the good arm so that the patient doesn't rely on it, but instead through intensive therapy which is about eight hours a day, five days a week for a couple of months or more, but just encourage and coax and urge that patient to use the seemingly paralyzed arm which sounds paradoxical but they can, they can make tiny little movements, and if they build on those, they can regain function.

coyote: neuroplastic change requires constant commitment and repetition to be enabled. undertaking the taub therapy requires commitment on the part of the patient and the caregiver. utilizing the constraint-induced therapy had similar success with another traumatic brain injury patient, army veteran christopher lynch. chris: the recovery does not stop after you get out of the therapy sessions, out of the classroom therapy. you go home and you keep doing it, you keep doing it, you keep motivation. it's the motivation that you need to have. cheryl: i was a little skeptical. i saw simplistic, repetitious movement in the therapy that he was doing. he had a mitt on his hand. it all made common sense to me but i wasn't too sure. i still had my questions, you know, is this really going to work? three days into the therapy chris woke up in the morning

and had had a dream. that was the first surprising thing that i felt meant something. he hadn't dreamt in two years. chris: my brain it felt like the brain was firing. it was like the more the more you work the brain, the more it it heals itself in a way. cheryl: on the way home from therapy, we were between here and montgomery, alabama, and chris automatically reached up and pushed the button on the radio with his left hand. and it was um, it blew me away. i looked at him and i was just extremely surprised by it and he looked at me and said, "what?" so i knew he didn't actually have to think

about pushing the button on the radio. it happened. taub: the main theme of ci therapy-- you either use it or you lose it and if you've already lost it, that's okay, you can get it back if you keep trying, coyote: use it or lose it -- in its simplest terms is at the core of our understanding of brain health. use it or lose it is also a mantra for approaching any cognitive challenges that we might encounter, even when you don't expect it, as is the case with many people who have undergone chemotherapy treatment for cancer and were shocked to find themselves suffering from a condition called "chemo-brain." sueann: i was diagnosed with stage 3 breast cancer 2 days before my thirty-fifth birthday. so, a birthday present i was not expecting, you know, when you're told that you have stage 3 cancer, you make different decisions than

you would before then. so, i started to do my research to find out what can i expect to have happen, you know, i knew my hair was going to fall out, i knew i was going to be nauseous, but beyond that, i wanted to know you know what is this like? um and, i, you know, found out that there's this thing called 'chemo-brain' that might affect my cognitive abilities, which really scared me because i was young, i was active and to have to deal with any cognitive changes was, you know, just salt in the wound. fleishman: up until recently it was assumed that cancer affects the body in three ways. cancer can spread locally in the area where it grows, it invades the lymph nodes and it can get nto the lymph system, or the sort of drainage system in the body and then finally it can get into the blood supply, but recently, people have figured out there's sort of a fourth dimension called the cytokine

phenomenon cyto for cell and kine for protein, and now it's pretty much routinely accepted that cytokines, or cell proteins, are produced by cancer cells as they grow and they can affect remote parts of the body even where there aren't cancer cells or tumors growing, and it's believed that this may be implicated in some of the cognitive effects that occur with cancer and possibly with chemotherapy. merzenich: we know in some instances it can effect the way the neurons of the brain are wired. that insulation on the wires that's so critical for shipping information around in the brain and then of course it can also effect cell division. which, in some areas of the brain it's important you have the capacity to generate new neurons. we know that that's especially important in the hippocampus. hippocampul function is critical to memory. sueann: i thought i was losing my mind. here i had cancer and if that weren't bad enough i couldn't you know, handle daily things. and it affected my enjoyment of things as well.

you know, i couldn't read a book, i couldn't get through a chapter of a book. so, it was a little frightening, and i wasn't sure if this was going to last, because i have heard that chemo brain can persist and in some people and i didn't know if i was going to be one of those people. merzenich: and we know from actually looking at the brains of people that have gone through chemotherapy. that they are responding abnormally, and they're responding abnormally in these critical centers that relate to memory to remembering, that relate to controlling the representation of information that's coming in rapid sequences or is played out in their actions in rapid sequences. so, just like an older person the brains of someone whose been through this chemical poisoning, and that's what it is, it's chemical poisoning, have slowed down and are operating much less accurately, and are doing a much poorer job of supporting a good memory. sueann: after i started chemo, i started doing the cognitive training and just felt like, okay this is a formal program you know, where i'd read yeah, crossword puzzles help,

but this was a very targeted specific program to be doing and i felt like okay, this is just going to push me over the edge. it's almost like the insurance policy to make sure that everything is going to be okay. merzenich: we know that with formal of cognitive training you can actually drive fairly significant recovery. and we've actually seen a number of wonderful cases of reversal of this condition in control studies. and it occurs because we're attacking, you could say, through intensive training we're reversing the same kind of process that we reverse in any brain that's struggling cognitively to remember or to control our actions at high speed these are improvable faculties, just like they're improvable in older people in general. coyote: when we come back we'll see how new computer aided therapies are treating people with post-traumatic stress disorder as we continue to explore brain fitness frontiers. gail moore: i had no idea getting old was going to be such a blast. you can express your love and your caring about people

that you might have been inhibited about expressing before far more freely and this program has helped all that. it's helped in levels emotionally i mean, you think it's just about the brain, but emotions are in the brain. so, the entire experience for me has been absolutely fabulous! absolutely fabulous! babette: hello, i'm babette davidson, and absolutely fabulous is a great way to describe the programming that pbs offers you every day. programs like brain fitness frontiers. we're part of your community and we need your support to continue to educate and enlighten you with the latest advances in science, like neuroplasticity and cognitive training. nothing is more important than feeling involved, engaged and on top of your game. and as we age, we know that it becomes harder and harder to do that. but we can use cognitive training to gain back what we might have lost along the way when you contribute at the 60 dollar level,

we'll send you a dvd of the program you have been watching, brain fitness frontiers. contribute at the 120 level and receive the complete brain fitness dvd library. when you contribute at the 200 dollar level we'll send you the cognitive training program brain fitness: sight. this single-user program is designed and clinically proven to help you drive more safely and cut your car crash risk by 50%. it also will help you remember more visual details when traveling, reading a medication label, and in every vision-rich task. while this may just look like a series of fun games-- and the games are fun! i know, i've tried them! -- it is really so much more than that. exercising your plasticity is hard work and the tools in brain fitness sight make the most of your efforts to build the right results. edwards: when something is wrong with us, we want to take a pill to fix it. often, physical exercise can help us cure or overcome

physical difficulties such as back pain but we'd rather take a pill to deal with our back pain. and i think we probably have the same attitude about our cognitive and visual information processing function. we want to take a pill to fix it we don't want to have to actually do an exercise to fix it. babette: these programs aren't used to only combat aging. your adaptable brain is ready to be trained any time. and that training can aid with many conditions that affect cognition. in fact, the brain fitness program has shown strong results in combating chemo-brain merzenich: we know that through the course of chemotherapy, the chemicals that are designed to kill to stop the division of the cells in the cancer that are going to maybe save your bacon in fact, have damaging consequences in the brain. so just like an older person, the brains of someone who has been through this chemical poisoning and that's what it is, it's chemical poisoning have slowed down and are operating much less accurately and doing a much poorer job of supporting a good memory.

sueann: right after i was diagnosed, i was pretty overwhelmed and you know, things became a little bit difficult in terms of my attention span and things like that posit science, the makers of the brain fitness program, they thought, well maybe this will help with chemo-brain as well, so i was eager to do it. i did the program i think i did it 6 days a week for 40 sessions, an hour at a time and it was actually kind of fun. within about 2 weeks i started noticing i could get further in that new york times article than i could before. i could remember why i walked into the room. i could remember what i was getting at the grocery store and so it really started to make an impact within a short period of time. babette: if you're able to flex your financial muscle for public television and for the good of your own brain contribute at the 365 dollar level and we have something very special.

it's the complete brain fitness package. it includes the cognitive training programs brain fitness sight and brain fitness sound which together will work to improve your brain's auditory and visual processing -- helping you think faster, focus better and remember more. if you've already made that call of support, we thank you, if not please go to the phone now and make that call. not only will we thank you but your brain will thank you too. this is such a great way to support public television. we're so pleased to be able to give you this incredible offer. if you were to purchase this anywhere else it would cost you over 650 dollars. the value of the gift far exceeds the amount of your contribution. we're able to do that to support public television and remember you receive both programs which have been clinically evaluated for their efficacy. merzenich: as we created these cognitive training programs, we knew that we had to determine whether or not and how effectively they worked.

so we enlisted the support of scientists from the mayo clinic in rochester, which is one of the great research centers in the united states. and with a special emphasis on aging and we also enlisted the support of a wonderful center, scientists at a wonderful center at the university of southern california in los angeles to help us in evaluating the effectiveness of these programs. and they found these programs really work! what was recorded in the study of course was there was very substantial impact on your memory, or on your cognitive operations. were equivalent to a person operating as if they were about a decade younger. babette: with so many of us putting off retirement or starting second careers, improving speed of thought and action is critical. morgan: i mean, i feel a lot younger than i did a year and a half ago when i was trying to figure out ok, what am i going to do with myself? and you know i, for those of us who are older and have always been actively in a professional situation, isn't it wonderful to know that you can keep going

and keep expanding your horizons? babette: and when you do retire, it can be much harder to remain cognitively active and much easier to retreat. fodor: one's quality of life is very much dependent upon being active and,staying with it both physically and mentally. and, uh, the two actually, i think, is somewhere, somehow coupled, so, i think its well worth doing it. um,if you can't engage, then what's the point of being there? merzenich: but the main thing that i see happening in older people is i see them wasting their older years and i think this is a sad thing. i saw my mother basically lose effectively the last decade of her life. for several years she had to be in the presence of others because she couldn't take care of herself and then she slipped into alzheimers disease.

now, i know that life does not have to end with so many wasted years, and that's, really what this is about, it's trying to maintain the fitness of the brain so that the brain life comes closer to the life of the body. so that there are more years in which all of those things that you love in life, all of those things that you love about life all of those people that you love in life, are fully engaged by you as an interesting, growing, intelligent, useful person. and of course this is exactly what we're trying to achieve. babette: at pbs, we're all about giving you this kind of programming, this kind of information about your brain and the amazing possibilities of change throughout your lifetime. we're also asking for you to support this kind of programming. when you contribute at the 60 dollar level, we'll send you a copy of this tv program, brain fitness frontiers. when you contribute at the 200 dollar level, we'll send you brain fitness sight.

this cd-rom based cognitive training program is a series of computer-based exercises that actually speed up and sharpen how your brain processes and remembers visual information. when you can contribute at the 365 dollar level, that's just a dollar a day for pbs we'll send you the complete brain fitness package which includes the dvds of the brain fitness television series and the 2 computer based cognitive training programs brain fitness sight and brain fitness sound. like brain fitness sight, brain fitness sound is the complementary cognitive training program that's designed to improve the quality and quantity of the information that you hear, so that you can get more out of every conversation, you improve confidence and your connection, you will be at the top of your game. these cognitive training programs are all engaging and are all working your brain at just the right level, never too easy and never too difficult, just right for you. for instance the high and low program encourages

faster sound processing to help the brain respond to even the quickest speech "tell us apart" gives the brain practice distinguishing similar sounds to help it interpret speech and store clear memories of it. "match it" aims to improve the clarity of memory by sharpening the precision with which the brain processes sound. or "sound replay" pushes the brain to remember information in order, which affects the ability to engage in and remember conversation. both programs retail for over $650 and are available to you for your contribution of just 365 dollars. and when you contribute at any of these levels, you will receive the e-newsletter, "brain fitness news." the brain fitness frontiers thank you gifts are all about transformation, and the critical transformation begins when you make that pledge of support. and your support, at whatever level you can contribute,

is vital to the continued health of your pbs station. remember, you receive brain fitness sight and brain fitness sound for your contribution of 365 dollars. these are not mere games, they are brain-training exercises and they do take work, but the pay-off is so worth it. doidge: just as when you want to improve your cardiovascular health, you have to push yourself. you have to really push yourself cognitively and pay very, very close attention just to increase uh,your cognitive ability, and reading the paper won't do it, and doing the things you like, dancing the old dance won't do it. but dancing new dances where you have to strain to learn the steps will do it. and so, the cognitive approach for auditory memory by posit science is very carefully designed so that there are incremental increases all along and they keep you interested um,as you go up the ladder to improve cognition.

babette: before we go back to the program, i want to urge you once again to call the number on your screen. this station depends on your support to make the quality programming that you see everyday and we hope you'll see to it that we can continue our mission of bringing you the kind of information and science that you can use. if you've already called, thank you for your support and if not, now is the perfect time to make that call. thank you so much. coyote: as we've seen, approaches based on the power of positive neuroplasticity can help people regain function carve a path toward clearer thought, and possibly even minimize pain cycles. psychologists, also, draw on the power of neuroplasticity, with their approaches to bettering mental health.

doidge: we know that a form of therapy called interpersonal therapy, cognitive behavioral therapy, and psychoanalytic psycho therapy all reconfigure the relationship between departments in the brain for depression and anxiety and the thing about using a talk therapy to do it as opposed to using a medication is you're just focusing on the problematic circuits in the brain so a talk therapist in a way is like a micro surgeon of the mind when the therapy is going well working just on the circuits that's the memories and the learned behaviors that are problematic. coyote: that kind of intervention takes a science fiction twist with a therapy designed to treat post-traumatic stress disorder. the therapy is a combination of precise talking therapy and virtual reality, called "virtual iraq."

skip: i think we've come to understand over the last twenty years that anything you experience or anything you learn, results in some change in the brain. when you develop ptsd from an extreme experience in combat the brain does change in some ways. we had the idea that perhaps there might be some folks coming back from the war in iraq and afghanistan that would be suffering some of the symptoms of ptsd much like the vietnam era vets had gone through. and, we thought about the idea of developing a treatment in virtual reality whereby you, put a person back in the scenes in vr, of the traumatic events that occurred to them, but in a very graduated way, and help them to process their emotional memories in a way where it's not just relying on imagination or reflective memory or anything,

but rather putting them back in the scene so that it can kind of open up some of the things that have been bottled up. this actually is what we call exposure therapy. mclay: exposure therapy is based on a very old piece of psychology called learning theory. which basically talks about why we remember and focus on particular things and why things just sort of fade out of our consciousness. if we think about a very common everyday phenomenon where this happens, we stand everyday inches from pieces of metal going by at fifty-five miles an hour and weigh two thousand pounds. that should freak us out. but it doesn't because we do it everyday. our brain has just started to ignore the fear associated with that. coyote: but in cases post traumatic stress disorder or ptsd, it is the seemingly innocuous events and associations that can trigger fear and panic. such was the case with master sergeant robert butler. robert butler: i had some issues

and i actually talked to the chaplain and hand talk to the youke you to gknow, a psychiatristtal because you have some signs that i think might be post-traumatic stress disorder." and um, i scoffed him off, you know, there's a lot of bad stigma with that still these days. kelly butler: i noticed changes right away, um... just was not as open, he was always the one that made you laugh, the one that would tell the jokes, everybody loved being around him for that reason, and there was no more of that, robert: my wife would tell you i didn't laugh, i didn't smile, i wasn't interested in doing things that we used to do together, going out, you know, just in a shell, i was at the store with her, and she said, hey, why don't you go grab some toilet paper, and i said, sure thing and i went over there, and there's like a hundred kinds of toilet paper and i found i was so overwhelmed, i couldn't make a decision

on what kind of toilet paper to get, you know, she walked over there and she was like, hey, are you going to get some toilet paper and i was almost in tears because like,i couldn't make a simple decision. coyote: but seeking help was not an easy decision. avoidance is one of the main difficulties in getting patients to deal with their ptsd. robert butler: the last thing you want to do is talk about what happened, because you just spent all this time avoiding it because it makes you feel bad, or you know, just trying to put it behind you. coyote: at the behest of his wife he decided to seek help and qualified for a study of the virtual iraq program. skip: somebody with ptsd, just say from iraq, just the thought of sand at the beach may evoke a ton of memory that is painful and what do they do? they avoid going to the beach, um,and when you avoid something you get a sense of relief, all of a sudden it like (sigh) and that reinforces the avoidance!